Stent placement for the treatment of portal vein stenosis or occlusion in pediatric liver transplant recipients

Abstract

Purpose: To evaluate the efficacy of stent placement for the treatment of portal vein (PV) stenosis or occlusion in pediatric liver transplant recipients.

Materials and methods: Written informed consent was obtained from a legal guardian, and our institutional review board approved this study. Percutaneous (n = 10) or intraoperative (n = 2) stent placement was attempted in 12 pediatric recipients (age range, 6-102 months) via the percutaneous transhepatic or inferior mesenteric vein route. Stents 6-10 mm in diameter were placed. Technical and clinical success, complications, and patency of the PV were retrospectively analyzed.

Results: Technical success was achieved in 10 of 12 patients (83%) and clinical success was achieved in eight patients (67%). Eight of the 10 patients in whom technical success was achieved (80%) remained healthy with a patent PV during the 10-58-month clinical follow-up period. One patient with technical success died of acute rejection without recurrent PV complications and another died of acute rejection after stent replacement as a result of an hourglass deformity of a deployed stent with partial thrombosis. No major procedural complications occurred.

Conclusions: Based on this study in a relatively small number of patients, PV stent placement seems to be a safe and effective method for the treatment of posttransplantation PV stenosis or occlusion in pediatric patients.